Knowing the Surrogate Body

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Surrogate Motherhood:International Perspectives

Edited by

RACHEL COOK

andSHELLEY DAY SCLATER

WITH FELICITY KAGANAS


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17

Knowing the Surrogate Body

in Israel

ELL\i TEAlAS

1. INTROI)IJ( l-ION

S KKO(;~I~EMOTH~KHOOI) IS 311 anomaly that disrupts familiur conceptions

of motherho od, kinship and family (Mac klin (1991) ). I 13contracted surro-gacy, :I woma n ma kes a preconception agreement to \vaivc her parental rightsin exchang e for a paid fee (Furquhnr (1996) ), ;I practice that ca lls som e of th

m ost basic structure s of soc iety into question. Social relations created in surro-gac y deviate fro m the traditional mode l of marriage which centres sexua l rel

tions and fertility issues around two mem bers of a heterosexual couple.

Moreover, surrogacy de fies mainstream ussum ptions that identify pregnancywith the birth mo ther s com mitme nt to the project of subsequent lifelong soci

mothering of the children to who m she has given birth (Farquhar (I 996) ).As SLIC~I, surrogac y threatens clominrlnt We stern ideologies that presum e an

indissoluble mother-child bond (Gnilcy (7000); Fnrqdlar (1996) ). Surrogacyhas been theorised as bringing about the gradual decons truction of mothe r-hood (Stanwo rth (1987) ) separating the pcrccive d unity of the maternal rolinto gen etic, birth, adop tive, surrogate and other matern ities (Sandelow ski(1990) ). To this point, conservative voices express concern over the frqmentn-tion, lack of connection, and loss of maternal wholeness, rind treat surrogacy n deviance that mu st be censured (Farcphar (1996) ).

Because surrogacy does not comfortably fit the cohesive and consistentsyste m of conceptunl categories of We stern cultures, cultures are chdlengedto develop wuys of dealing with itsanonmlo~~s connotations (Davis-Floyd(1990) ). Colligan (X)01:3) remindsLIS that anomnly is not simply a problem of

~classlhcn tion but ,111emldicd status that mu st be worked out in every&)social situation s. In the following, I lvisli to call attention to the negotiation

tactic s that dealing with classifica tory contradictions can engender in wom enwho participate in surrogac y agreem ents and the tcclitio-me dical professiond sthat accomp any them through the process


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How do surrogates ad intended mothers accomm odate rind resist the ;~nalous connotations of this reproductive strategy? How do they asses s and netiate their own positions in Israeli society through surrogacy? I will argue throughout the surrogacy process, surrogates and intended mothers, togethwith doc tors, nurses and dtrasound technician s, collectively generate alations in received scripts abou t the maternal nature of pregnant lbodies and non-m atern: mn kcup of infertile bodies.

I shall engage the conce pt of authoritative knowledge in order to shed on these questions. This concept refers to the way th:lt knowledge is producdisplayed, resisted and challenged in interactions (Dav is-Floyd ud Sar

(1997:21) ). In their comp rehensive edited volum e on chilrlbirth and nuthor

tivc know ledge, Da vis-Floyd and Sargent (1997) bring together ethnographresearch on childbirth in 15 coun tries. The y show that, while techn o-med icwa ys of knowing increasingly domina te obste trics worldwide , indigenmod els of authoritative knowledge still exist and intcractionnl co-operation

nccomm odation between biomedicine and other ethno-obstetrical syste ms possible.

The classificato ry challenges that surrogac y raises ma ke Israel into a partilarly interesting place to stud y surrog acy. Israel is a pronatrilist socie ty wJew ish-Isrncli population will try anything in order to have a child (K(1997) ). This cultural cult of fertility (Bzslington (1996) ) amo ng wom en has been described as a social pressure to reproduce that horders obse ssiven ess and irrntionality (Shalev (1998) ). Israels pronutalist impulse mad e it into one of the leading countries in the world in the research and dopment of ne\v reproductive technologies. This small country currently hthe highest nu mber of fertility clinics per capita in the world-and Isrnational health insurance funds IVE treatm ents forLIP to two live births forchildless couples and for wom en who want to become single mothers (Sh(1998); Win (1997) ). The option of not becom ing a mo ther is virtunon-e xistent in Israel, while solutions such as international adoption are

considered to be secon dary options when gene tic parenthood is possible.The Israeli surrogac y law of 1996 mad e Israel the first and only coun try i

world where all surroga cy con tracts are publicly legislated by a governincn


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appointed com mission (Kahn (1997: 171) ).? According to the law, an approvalcom mittee ~~1s nominnted by the governm ent henlth minister to screen nil

potential surrogacy agreem ents in Isrd. In its zim to cope with the conceptualthreat (Davis-Floyd (1990) ) that surrogucy prese nts, the surrogncy lawremo ves the praaice from everyda y life, limiting its avuilability and subduing itboundnrp-threatening conno tations. The practice is not officinlly encouragedand is strictly limited in scope to adult Israeli citizens. It is offered only as 3 lastresort to couples v&rein the female pat-trier has no wo mb , has been repeatedlyunsu ccess ful with other reprod uctive strategies, or who is nt n severe health riskin pregnan cy. While the law itself can be interpreted as a frame work throughwhich the state officially recognizes surrogacys nnom alotts connotations rind

aims to den1 with them, rhis is not the conccrn of this chapter. This chapter usesethnographic research to address the wa y rhat surrogates, intended mo thers,and health professionals attem pt to solve the nnotnaly of surrogncy in practice,engaging intuitive, technological and medical knowledge sys tem s in the proce ss.

3. THE BODY IHAT KiYOK 5: INTlllTlVE KNO\Yl tl)(;t:

111 their exploration of intuition as authoritative knowledge among Ame rican

mid wives , Davis-F loyd and Dav is (1997) claim that Ame rican iiiidu,ives usintuition 3s a tool for knowing the pregnant body in childbirth. While trainedin the intricacies of technotnedical birth, the midw ives made decisions during

labour based on their inner knowing , even when it opposed external, tncd-icalised signs. In surroga cy, intuitive knowledge of the pregnancy wa s employedby both surrogates and intended mo thers as a source of authoritative knowledgeconcerning the pregnan cy. Ey constructing a situation in which the intended

mothe r know s the pregnant body inhabited by the surrogate, intended tnoth-ers were able to claim ma ternity while surrogates were able to disconne ct emo-

tionally frotn the pregnan cy.Ky intuitive or indigenous knowledge of the body, 1 refer to the internal, gut

feelings and instinctive response s of the individual that arise as a result of lis-tening to their own internal, embodied voice s. It is the act of or faculty of knobs-ing or sensing withou t the use of rational proce sses; imme diate cognition(Amcricnn Heritqe Dictiom zry (1993), cited b,- Davis-F loyd and Da vis(1997317) ). Often, intended mothe rs began their narratives with a determinedstarema n linking their bodies with ma ternity rhroughsuch intuitive knowledge.Leah, an intended moth er, claimed:

I alwa~.s kne w that I ~vould have m y olvn (child). I k ne\\- right here (she ma kes a fi


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For Leah, and other intended mo thers like her, this inner knowlcdg c carthem through up to 25 IVF attempts and countless other fertility treatme

over periods of up to 17 years or mo re. Instin cts and gut feelings also acco mpid their choice of a surrogate. In their search for the right surrogate, primarily relied on their bodily and cnmtiona l instincts as indicators of

patibility. These signs were prideged over measu rable data insisted upon byapproval com mittee, such as psychological, physical and social qtitucle te

Sarit, an intended mo ther, let her body indicate to her when she had me t right woman:

When you meet the rlght \vom ;m, YOU feel it in vol~r stoma ch, xld you know right thing. .that this (womnn) is xvhat best suits me. We had immediate chem is

Surrogates enlerged as strong believers in intuitive know leclgc 3s wNarrative accounts of both wom ens first encounters with one another reberated with 3 vocabu lary of chem istry , immed iate conne ctions and clused to define the intcrunl physical trigger that these wom en feltupon meetingone another for the first time . Tw o thirds of the surrogates and intended mers interviewed clescrilxxl instnnce s of imm ediately recognising one anothefirst sight even though they were strangers, assuming that cosm ic interventiohad caused their meeting.

Con structing one another as the right surrogate for the right couple, rogates and intendd moth ers were able to cleco mm odify anal re-nnturnlise surrogncy process even before the comm crcinl contract was signed. The concof the right pnrtner in the proce ss served to mininiise the randonuless ofrelationship in favour of a cosm ically ordained nature, imposing n certain ural and mo r,il inlpcrntive on the surrogacy proce ss a s a whole. For inten

mo thers, it served as 3 reassuring sign that th ey were nieant to have a chiwhile for surrogates , it constituted a sign that God and nature had mea nt theln to become surrogates.

Both wutnen drewupon their intuitive conne ction in order to define motherhood as a product of internal knowing , allowing them to attach their mean ings to the pregna ncy. Surrogates were thus able to credit their intendmothe r with know ing the pregnancy instead of them , which enierged as ;I egy for dismissing nny expectations for their own emotional attachment topregnan cy. While awaiting confirnxition of pregnan cy, surrogates refuse dacknow ledge any internal sign from within their bodies thatcould signify theresult, urging their intended mo thers to see k the answ er within them selveMash~i, ;I surrogate, emphasised this point:


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Lvhether her surrogate had knomm the pregnancy to the same degree that Ayala, felt by proximity:

From the veq beginning I felt pregnant, from the min~lte they inserted the emb rfelt like it wa s m y hod!. going through it No t onl!- on dn emo tional level bon :I physica l level it affected me . 1 really h,xd the same feelings she did-1 felt it.really like they sny :1 man xvh osc \vife is pregnant goes through it. I too really rhe nausea when there ~1;~s nau se,t .lnci the hearthurn when there was heartburdonr kn ow a bout her bllt I really felt \vh,lt she wa s going through outsldc feeling of respons ibility end p.iins on .~n emo tional level, 1 felt re,llly conne cted

The increasing legitim:~cy of her inner kno\vledgc of the foctus becameconvincing to one intenclccl mother, Rivka, that she claimed shed actually

pregnant during this period:

You know wha t, 1 say to C)rna thnt it is lucky that, you know , those hysterical nancies (fake pregnancy), it is lucky that I didnt have one of those . . . but the ferring part and the feelings, I felt exa ctly the sam e (~5 3 pregnant won i;in). Mdi,its what gives me lhe push to say, yes, I \vris pregnant, and not through a surroBecause I felt exactly \vh,tt she felt.

By cons tructing intuitive knowledge as a source of knowing the pregbody, surrogates and intended mothers work together to make their partnersh

in the pregnan cy more equal. T hey even out the surrogates privilcgcd placknowing the foetus by collabor~ti~cly cons tructing their own authoritaknowledge which aligns all intuitive and embod ied conne ction betwee n the

tus and the intended mother. In the following section, we will witness howtechnological viewing technique of foetal ultrasound is brought in to this as well.

Eiigenia Georges (1997:93) claim s that ultrllsonograph y cnn act as an especputcn t facilitator in the production and ena ctmen t of authoritative knowled g1Srigittc Jordan (1997) claim s that when inflchine-hrlsed claims contlict lvitwom ans own bodily experience , the latter is negated in favour of theuiiques-tioncd status and authority of medial knowledge. Conseque ntly, \vomc n

.spec ifically cxclud cd from techllo-c)iilclbirth, denied any input into their experience , and given the messnge that the only knowledge that counts is thntthe doctor.

I argue that this hierarchical distribution of knowledg e in technologicdlmed iated situations is inverted in surrogac y \vhen the surrogate herself


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ing the knowledge that she has of the state of her body (~~ordan (1%~) ) techno-med ical knowledg e is adapted ns a source for legitimnting the fictionnl realitthat the two wom en are constructing between them . The techno-medicalknowledge of the pregnancy is also comtnun icatcd in a structure that actunll)encou rngcs the intended mothe r to believe in the internrll me ssag es that her bodyis giving her.

By technological knowledg e I refer to surrogate and intended mo thersacco unts of their encou nters with ultrasound techno logy. Like in all births mod ern-day Israel, repetitive scanning is 3 routine part of surrogate pregtiati-ties, only more intense than in regular p regnancies. Although both wom en dis

cuss ed ultrasound in their narratives, it seetned to be more imp ortant to

intended mothers as it served to confirm the existence of the baby for them anden&led them to act out the culturally prescribed role of soon-to-be mo ther.

Ultrasound exten ds the sens ory abilities of the intended mothe r and adds thedimension of seeing to the inhcrct~t knowing discussed abow.- In this wayultrusoutid served 3s a proxy for the prcgtiaticy experience , giving intended

mothers the opportunity to become more relevant to foetal progress and tomo ve to centre stage beyond their stage-hand role vis-A-vis the surrogntes

leuding lady role (Snndelow ski (19%) ). The intended mo thers greater knowing participation in the pregnan cy via ultrasound enabled surrogu tcs to take

step ha ck, deriving n type of vicarious pleasure from w utching the intendedmother bond with the technological image of the foetus.

Con sequ ently, ail the surrogates interviewed saw importanc e in huving theirintended mother accom pany them to every ultrnsound appointment. Thc sc otttings strengthened the surrogate-intended mothe r relntiotiship, bringing themcloser together by mak ing intended mo thers feel more like pwtne rs in the preg11at1cp. The technological med ium thus reinforced the intuitive conne ctionnlrendy e stablished by the wom en through their own indigenous sottrc es.

Otte surrogate claimed that she SAM the ultrasound as at1 event in which heintended mother could take part in the pregnancy:

It ~~3s importan t to tnethnt she be present It 311 of the ultrasounds, for instance.Because It was itnporrant tu me that she go rhrouph the \vhole expericncc and rhat shsee rhe Lvliole experience . I have no problem \vitli a \votii:tn coining in [ro the vinal ultrasound, ET] and she said to me before x vc \vcnt in, if you dont \vdntwont cotnc in, Ill wait ourside. 1 said no \v:ty. About those things, I m,tde sure tshe took part in everything . Becaus e it is really imporr;tnr to me th,tt she go rhrougand feel the whole experience exncrly as I do. That is the \v:~y I \vanted it, th:tt she my prttier, 3s much 2s possible.

Likew ise, all of the surrogates intervie\ved for this stud y dismiss ed their


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from their accounts of these situntions, making their OWI~ ubjectivity invisible.Accordingly, Orna, a surrogate, dismissed her intended fathers shj-ness at seeingher pnrtially unclothed during an iiltrasound by assuring him that he was not see-ing her-Orna, the woman. Extr,lcting her presence from the scene, she told himthat all he was seeing was a stomdl that separated him from his child: I saidto him, dont hc shy, just rcmcmber, this is yours (pointing to her stomach).Dont even think about this stomach, it is nothing, just ;I stomach, only thinkabout what is inside it.

Ultrusoiind provides visual access to the foetiis in-zft~~~o, enabling theintended motherY to conceptualisr the foetus for the first time apart from thesurrogate. As she lays in the supine position and is scannecl, while her intended

mother (or couple) stand with the doctor, I0 the surrogate symbolically becomes3 silent participant, a transparent medium for technologicnl viewing of thefoetus.

Interestingly, while ultrasound has been critiqued for opening the inside ofwomens bodies for visual inspection, leaving their body boun&ries thoroughlytransparent (Van der Ploeg (1998) ) here it is this same transparency that is usedby the women thcmselvcs to define the maternal subject. The ultrasound pre-sents the foetus ns an individual entity, alone on the screen, as if removed fromthe surrogates body. This visunl dislocation of the foetus from the surrogates

body aids her in clisengnging herself from the pregnancy while providing thecouple with ;I direct mode of communi~~ltion with the foetus on screen. Insteadof merely demoting the surrogates body to a secodiry order of significaiicc(Georges (1997:99) ), ultrnsound enables her to promote the intended mothersbodily and visual experience to :I privileged place of significance ad to supporther own emotionnl disconnection.

Surrogates rarely mcntioncd their own participation in ultrasoiid, focusinginstead on the intended couple aid their excitement at seeing the image of tlieilfuture child on screen. None rclnyed personal excitement nt seeing the foetal

image, claiming boredom rind disinterest, or narrating an excitement centredentirely LI~OII their intended mothers happiness. hlusha asserted that she didnot pay particular attention during ultrnsound q~pointments, claiming: hlostl)


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Riki was able to establish a direct link of comm unication with her awatwins, keeping them close to her, in her own home, even while they develop

in another wom ans wom b. Yael also attempted to embody the pregnancy

keeping the ultrssounc l imnge s with her at all time s. She carried them in ;I envelope in her purse, removing it delicntely to show them to me 3s though

photos were part of the awaited child.

The ultrasound photos complete ;I new hierarchy of knowlcdgc creathrough technological intervention in surroga cy. By giving sonogrnphers power of clinically interpreting the sonogram and controlling distribution technologically prduced knowledge of the foctus, foetnl ultrasound membodied knowledge of the pregnancy less exclusivean d more dcpcndent upon

technology (Snnde lowski (1994) ). Con sequ ently, sonograp hcrs achieve 3 ileged position that allows them to intervene in the social relationships of wom en to the pregnancy. By focusingon the intended mother during scnn s, theyshape her into :I moreeq~d knower of the foetu s. T his proce ss is finalised the intended mother taking home the souvenir images o f the foetus. Her possion of this foetal artefac t finally ma kes her into the direct disciple of the nological knowledge of the pregna ncy.

Con trary to prior research , this hierarchical distribution wo rks towa rds same aims that the wom en themselves co-create intuitively. While in m

cases, sucli as the normal technologically manag ed childbirth descrihcd Brigitte jord~in ( IYY7), the com petition betwee n indigenous and technologicall)derived know ledge lends to the wom ans internal knowledge being overriddthis case cmerg cs cliffercntly. These wom ens expressed knon,ledge about thodies is not ignored, denied or replaced hy another conflicting version of ity. Rather, these two types of knowledge collaboratively produce and maintthe sam e fiction tog ether-th:lt the red body that is conne cted to the pnuncy belongs to the intended mother.Thus, machine bnscd an d intuitiverecords of the pregnaxy do not serve to negateon e another but serve as ~1

resource for justifying theWOII~XIS own bodily claim.The surrogates transpnren cy and disrupted onene ss with the foetus duri

ultrasound enables her to show her emotional distance from the pregnan cy to emphasise the intendeci mother s strong connection to the foetus. Viewing foetus and maintaining foetnl pictures m inimise s the intended moth ers distafrom the foetu s, equalising her position with the surrogate and giving heropportunity to enac t culturally defined maternul scripts and claim her foetuyet another wa y.


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the ptient as an ambiguous entity that combined bothWOI~CII in it wh ile pro-viding legitimation of the intended mo thers maternal claim. I now cspandupon

this construction of the intended mother as a hybrid patient and the way thathis fiction encourages the wom en to engage it ns an additionnl source in theio\vn collaborative effort. Riki, nn intended mo ther, explained how importan t ~vas to both heran d her surrogate that she be present at the doctor nppo intmentsand be the muin actor in them :

She refused ro ler rhc doctor hegin his check-u p wirhour me . Even when I \vas thirminutes late one time, she mtcle him wait. She said that rhi\ IS Rikis baby an d that she

had to he here.

Surrogates &o seem ed to actively define the intended mo ther as the recipientof medical care, demunding her presence at every check-up. Rinat, n surrogate,remembered the day that the embryos were implanted in her won7h:

She [rhe inrended morhcrl \ras late, and I kep t m aking thr do ctor \v:lit. I said, the willcom e. She xvi11 com e. And the poor thing WJ S stuck in 3 traffic Jim. In rhc end arrived at the ldst niinllTc before he co~lldnt wnit an) L onger.

In both case s above, the doctor is 3 co-conspirator who collaborates with thwonlen in their effort to designate the intended mo thers statu s in the preg

nancy. One surrogate, who was in the beginning stages of surrogacy, asked mif I knew of any sympathetic doctors that could nccon~pany herand he rintended couple through the process. I want a doctor who understands, shsaid, who cm nxlke her [the intended mo ther] feel like she is going through

this.Intended mo thers cited their doctors elicOur;igci~iclit, with one won lfn

asserting that, He always treated nie like 1 wns the patient, even though it \vshe who wa s pregnant. Sarit,an intended mother, described a scene in whichthe doctor condu cting the emb ryo implantation gave rise to her first mnternal

feelings:I saw how they inserted the embryos into her womb, and Aat was really the first time

that I felt like :I momm y. 1 got there a little Llte, and they had already laid her down

on the bed. Then the doctor said, here comes the mom~~~~. And w-henhe said that I gotvery excited, because I really did feel r&t then like a ~nomny.

III her description, the doctor aids Sarit in encom passing the procedure as herown, promoting her identificf~tion with a procedure carried out on the surrogates body . Pronouncing her the nionuny while implanting the em bryos in

surrogates woinh lends an air of legitimacy to Snrits internal feeling o f connetion to the pregnancy. Elsewhere (Tcmnn (20011~) ) I discuss the way that surro

d d i l k l d i d di l i i Th


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strategic borrowing of med icnl authoritative knowledg e also aids them

emp hasising the natural, hio-genetic basis of the pregnancy for the intenmo ther, aiding her in claiming ma ternity for herself.

Israels sta te med icnl policies dso play a part in this con struction. Becau se tility treatm ents are subsidised by Israeli national health insurance for childcoup les, they are burenu~r~itic;llly considered ns belonging to the intenmo ther. 1Soth the hormonal treatm ent aimed a t increasing the intended motheegg supp ly, as well ns hormone injections for prep;lring the surrogates wfor emb ryo insertion are considered by the state to be fertility treatm ents forpatient---the intended mo ther. Intended mo thers were usudly the ones to the clinic for the results to the pregnancy tes t, and in more than one cas e, a

tor had personally called the intencied mothe r to deliver positive results tlong-stnnding patient, who ~oultl then inform her surrogate.

The medical syste m structures surrogacy so that the intended mother more m eJicnl knowledge of the pregnancy than the surrogate does. Again, exa ctly this hierarchy that enables the surrogate to invert the situation inown interest and equnlise her anJ her intended mothe rs participation inpregnancy. While one surrogate informed m c that the doctor had two filespled together. Tw o files that were one; another surrogate claimed that she no file, I ~v:as only part of her (the intended mo thers) file. This evidence

need for the two Wom en to merge in order for the process to succeed led Oto explain: My body cou ld not do it aithout hers.

The unitary patient construction was evident in other w ays as WA . Doctprescribed mcd ical prescriptions and appointm ent referrals in the intencmother s name, and she wo~dd buy the medicines and dispense them to the rogate. Intended mothers often &scribed themselves as middlemen between doctor and the surrogate. I M U the connection betlveen the doctor and her frothe time we began the proce ss until the third mon th of the pregna ncy, Saritintended mother claimed, most of the time she didnt even need to come

me . I would go to the doctor und then give her what she needed.Orn;i, a surrogate, saw the doctors referral practice s ns 3 chum iel throu

which respon sibility for the pregnnncy could he delegated to her inten

mother:

All of the prescriptions h,lve to be on her nam e, b ecause she has to ~ay for then lpays the mon ey. It is just as if I give you ac~nol (paracetamol), but it was bough111~ ame. So what? But if you go to b11y medicine th,lt is on someone elses nanlcwont give it to you. So you bu)- It on your name, :und then you give to someonethen what do the! care, after you bought it, its your respon sibility. But the checwere in my name.

Obtaining and delivering the required med icd drugs wn s con sistent


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perm ission for her to sta y with her throughout the birth, in Israeli situations imm ediate niedicul sta ff is informed that it is surrogac y rind treat it accordin

1 special protocol. From the surrogacy narratives of this period, it becam e that the mcclicnl staff actively interacted with the WO ~CII in shaping themone patient.

Rinat described how the head nurse co-conspired with her to construct h

and her intended mo ther 3s ;I comb ined patient:

1 said ro her,when the!- hospitrllised me, you arc going to bc hospirnlised \vith me .And she was with me in the hospiral. On rhc \veckcnd she stayed \virh me in the

pital. Thursday, Fri&y and Saturday she was in the hospiral. Next to me in the s

room. Yes. They gave us J room alone . And when a nurse came aho didn t kno

about our story, she srarted to yell. So I said to her, who are you yelling at. Riaway I said to her, Do you see her, rhdt is me. And she said, But you. . . . And I

to her, Do you see her, she is me. So she didn t underst:lnd whar it was and she w

to the head nurse and said ro her, In rhat single room I\vo Lvonien dre sleepin g.

she ans\vers her, Yes, 1 know. Those are t\zo wome n \vho areone. They are t\vo tharare one. And rhen she s;lt dowi xid explnine d it to her.

Rivku , an intended mother, dso described how the doctor encouraged hybridity by preparing them for giving birth:

Afterwards, when we went do~vn to do the moniror, rhcn (rhc foetus) didn t move.

rhey said okay, you have to go eat (plurnl),4 go ear (pltir,ll), and rhen come (plura

They were alway-s speaking incouple (form). Because of th:lt, it also g,lye me the feel-ing (that 1 was giving birth myself). Go eat, maybe while you (plural) eat she mi llmove

(the foetus).

The doctors use of the Heb rew plurd form to relay instructions for the

nant body made R ivka feel like she was half of his patient. Accordingly, I asked their doctor about how he related to the two w ome n, he affirmed his

in construc ting their hybriclity, claiming that: I would relate both to the

gate and to the intended mo ther, both as individuals and as one together.The heightened sense of identification with the surrogate and the feeling

being half of one patient led Ayala, an inteded mo ther, to narrate ;i swhere she virtudly gives birth to her twin s:

They gaveher (rhc surropre) an ope ration (Cnesarean secrion) and 1 wt outsidc ~n1 got up and sat down and at one point I fainted. I lost consciousness ,ind collapsedon

the floor for eight, nine, ten minutes. And it ends up thar exdcrly nr rhat SJIIIC mom

they extracred them (the t\vins) from the womb. And cvcryone said IO me, here you

pve birth to them justIIO\V. And at that very second I hadnr kno\vn whar was going

on insidc and she had gone in nlready at seven thirty. Eight, nine, ten minutes. Th

(the medic al staff) clerared mykg5 311~1 cxrracred our foetuses, I meal they took our


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In Ayalas account, it is the medical staff that actively encourages her to makethe conne ction betwee n her fainting spellan d the birth of her children. Once thechild ha s been born, a n agenda of separation replaces the former onen ess, and

the medical staffhands the newborn immediately to the intended mother. Thesurrogate is then given a room in the gynaecologicnl ward while the intendedmother is given a room in the new mothers ward. Surrogates are now notallowed to see the child without the intended mo thers perm ission, a rule tha

the nurses strictly enforce. A state social worker arrives to intermediate between

couple and surrogate. Both the intended mothe r and the surrogate receive ident-ity bracelets with the newborns name and the newborn is fitted w ith one o

each arm.Irma Van cler lloeg (( 1998) p. l(E), in her stud y of the Ne w Rep roductive

Technologies, claims that the NR Ts create a hybrid patient by fusing the sep-

ate individualities ofco~iples into a herma phrodite, unitary body . She see s thisnew individual patient as a deliberate erasure of female individuality for purpose of legitimately conducting invasive medical procedures on wom ensbodies, often for the benefit of other individuals that her body con tain-the

foetus and her male partner. The fern& patient herself is thus &mod to thbottom of the power structure that exists in her body.Returning to the case of medical intervention in surrogacy as described above

it is possible to shed light on the mo tivation of the med ical sta ff in creating hybrid patient between the two wome n until birth and the subsequent sepr-ation of the shared body into individual entities. The hybrid patient eme rges a metho d for treating the amb iguous situation that surrogn cy prese nts, being aeffective m echanism for making treatment more direct and efficient.Thus,health practitioners arc able to structure the surroga cy situntion-having onl

one patient, instead of two, throughout-by treating the two wome n as onduring the pregna ncy, rind promoting their separation after the birth.

6. ( ON< L(I5IOS

In this paper, I have shown how surrogates and intended mothers collaboratewith one another in producing their own interactive wa ys of knowing the srogate pregnancy. Th e wom en define motherhood as embodied, intuitive

knowledg e of the foetus ad locate that kllowledge--throLigh bdily adrhetoric construc tion-as external to the surrogates pregnant body anal as part


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actively pnrticipntc in rhis relocation of motherhoo d by associating alloXhn(J -medical authoritative knowledge connecled to the surrogate pregnan cy with thintended mother.

As a result, the authoritntive knowledge in surrogncy does not follow the sic top-down distribution of power in technological childbirth describedJordan (1997). Instend of being the helpless v ictim s of the tnedicalisntion childbirth, surrogates and intended tnothers a ctively co-crexte meaning in rogncy in collnboration with rcprcsc ntarives of the techno-m edical reSurrogacy thus provides n framework in which types of :luthoritative kledge regularly chnrn ctcrised as oppositional work together townrd the goal. Wo me ns bodily know ing rind techno-m edical knowing nrc set in an

active, collective process of constructing tnenning together.The question rctn:iins as to why surrogncy presents such a conceptual thr

to wom en, health pradtioners :d the state that they would all work togetto achieve analogous interpretations of surrog xy. The collaboration cm

seen ns 3 collcc tivc effort to find a cotitnitinble solution to surroga cys aalous conn otations. This is uccotnp lisld by achieving a singular d efinition

the maternal subje ct that is cnsicr for all to hxdle, decipher ad red (Harrou(1997) ).

These three fortns of knowledge work together to invert the threatening

ciation of families pieced together from d ifferent wom bs, eggs and spreplacing it wide traditional biogenetic kinship, in which maternal claim sestnblished through the body . In this man ner, all of the parries involved wor

elitninatc the incon sistency betwee n the pregnunt yet non-tnaternd surrogd the tnaternnl yer non-pregnant intended tnother. By confirming the intenmo thers maternal subjectivirp and conne ction to the pregnan cy a11 along, make surrogacy seem to confirm, rather than chdlenge, the Jewish-Israeli rural belief systeni.th

The collaboration also etnerges a s a cultural coping technique for diffusthe concep tual threat tha t surroguc y presen ts Eo Israeli culture by moutding inconsistent phenomenon to comp ly with Israeli societys protxdist core. slate regulation of wom ens reproductive bodies under the surroga cy lnw caseen to represent the sym bolic control of the Israeli body po litic, and the of health professionals in solving the anom alies of surrognc y can be seen Leffort 10 aid the state in mnititaining norm ative boutidnries around reprocCon. This, of course, is part of the rote of institutions. As xd~ropologist Doug las ( (1986:63); Hnrtouni (1997:125) ) put it, Institutions besto w sam e

they turn the bodys shape to their con\-etitions. They attempt to conventio


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&se and contain diversity or to render difference socially legible (Hartouni(1997) ) conse quen tly mnintnining the national, religious; andsocial structure.

Nntionnl goals also affec t the fema le actors collaborntion \vith thc sc institutions. III a coun try where wrm en are regarded as gatekeep ers of the nntionnl col-lective (Amir and Benjamin (1997) ), surrogucy holds the possibility of affectinboth of these wom ens place in the collective. Surrogacy thrcrltens to stigmntisethe surrogate as deviant of her natural, national maternal duties (Temnn(20011~) ) even 3s her gestation31 labour ac ts to bring the intended mo ther intthe realm of normutive Israeli woman hood. By creating ;I flow of indigenoustechnological and medicalised knowledge between them, centring m aternityand the pregnant body in the intended mo thers embodied spac e, thesewomen

collectively recom pose mnternal su bjectivity acro ss their bodily bound3 rics aconse quen tly turn any threats to the traditional view of motherhoo d and family on their had.

By redirecting the pregnancy awa y from her body and toward s the intended

mother, the surrogate circumven ts the culturd paradox that surrogacy presents:the deninl of her suppose d natural procreative urges and mntcrn nl instincts

n culture that valorises wom en mainly for their motherh ood. She incorporatesthe voice s of docto rs and nurses into her narrative, as well as the textud and

photographic representations of the pregna ncy, in or&r to lend concrete evidence and legitimacy proving that she is not denying ma ternity in the least. Othe contrary, she proves that not only sh e, but also the intended mother, the cloctors and the state all regard this pregnancy as not belonging to her, and that evenher body knew it was not hers. She thus reinterprets her seemingly deviantactions in terms of creating motherhood for another wom an, a purpose that one with the nations pronatalist ideology and not subve rsive of it (Tenian(2001b) ).

Together, these women co-scripted :I body with a specific social me ssngc, gen-erating n dinlogue about self and other (Collignn (2001) ) by ma king thintended mother s m;Irginnl body more normative. This enables her to movfrom the marginal status of non-mother to the normative status ofwom an/m other in Israeli soc iety (Kahn (1997) ) through a proce ss that threatensthe surrogate with further ma rginality. Their m utual effort to defy the thrcnt deviance thus created an interspace that held emn ncipatory possibilities for bothof them (Colligan (2001) ).

These wom en show that wcm ens bodies are not simply entities to be actedupon, but can participate in 3 conjoined agen cy (Colligan (2001) ) and in n c

authoring of their roles as mothers and mem bers of the nation-state. The act oconstituting the body in surrogacy is not a passive but ;I deliberate attempt bthese wome n to direct the gaze of society where they want it directed (Peace


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their supp ort, cncou rfigemeilt, guidnnce and helpful com me nts through out stages of this project. Iwould also like to thank Don Seemun, Tumar Rupaport,Edna Lomsky-Fe&r, Lauren Erdrcich, Svetlana Roberman , Tsippi Ivry, LimoSamimian, Adi Kuntsman , Avi Solomon, and Rhisa Teman for helping me

through curlier drafts of this paper. A find than ks to Rach el Coo k for her orial com me nts and to a11 of the wom en who shared their surrogacy stories me.

IIt, tEllI NLES

Amir, I) ,md Bcnjnmm , 0, Defining Encounters: who are the \vomen entitled to Israeli collective?(lYY7) 20 Ko md Stutlirs Inteym7 tio77al Forrm 63Y.Baslington, H, Anxiety Overflow: Implications of theIVF surrogacy Case md the

Ethia l md Alord Limits of Reproductive Technology in Britain (1996) 19 Korn

Stutiirs lntPy?7i7 tivm71 Foyum 675.

Benshushnn, A rind Schenker, JG, Legi timisin g Surrogacy in Israel (1997) 12 H~m

Re,mdtrction 1832.

Blyth, E, I wanted to be interesting. I wanted to be ~.ble to say Ive done somethi

interesting with my life: Intervie\vs Lvith surrogate nlothers in Britain (1994)

,[07~ym71 of Rr~pyotfurtiL~c~ ~777tl lt7fhut Psychology 189.Collig an, S, The Ethnogxphers body 3s text and context: revisiting and revisioning

body through anthropology and disability- studies (2001) 21 Disability.StldirsQutiyterly 1 13.

Gniley, C, Ideologies of Motherhood ,md Kinship in IJS Adoption in H Ragone

F Winddnnce T\\ine (eds), Itfcologi~s izjld 1 c~huologies ofhloth elhood (New Y

Routledge, 2OOOj.

Georges, E, Fetal Ultrasound Imag ing and the Production of Authorit,ltive Know ledg

in Greccc in R Davis-Floyd a n d C Sargent (eds), Childbirth ajd A~thoyhti~~c

Knozul~dy e: Cyoss-C:rdtun7l Pryspe~~tiucs (Berkeley, Ilniversity of California Press,

1997).Hartorlni, V, Ctdtrlrzl Co77cPptions (Minnea polis, liniversity of 12linneso ta Press,


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Knowing the Surrogate Body